Swollen Lymph Nodes In Children: Causes And When To Worry

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Lymph nodes are kidney-shaped organs in the neck, under the jaw (submandibular lymph nodes), under the chin (sublingual lymph nodes), underarms or armpit (axillary lymph nodes), groin, chest, and abdomen. They are a part of the immune system and play an important role in filtering the blood and killing bacteria and viruses. Swollen lymph nodes or lymphadenopathy is common in childhood and may occur due to bacterial or viral infections, such as colds, flu, or strep throat infectionⁱXA bacterial infection brought on by group A Streptococcus bacteria that cause throat irritation and inflammation (1).

Read this post to learn about the causes, symptoms, complications, diagnosis, and treatment of swollen lymph nodes in children.

In This Article

Causes Of Swollen Lymph Nodes In Children

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The following are the common causes of lymphadenopathy in kids (2)(3)(4)(5):

Respiratory infections
Viral throat infections
Bacterial throat infections, such as strep
Viral infections, such as flu, mononucleosisⁱXAlso known as kissing disease, it is a contagious infection usually associated with the Epstein-Barr virus , and chickenpoxⁱXA highly contagious viral infection that causes itchy and blister-like rashes due to the varicella-zoster virus
Tooth decay or abscess
AbrasionsⁱXCuts and scrapes on the skin that happen due to contact against a rough surface , burns, or insect bites
Scalp infections
Skin infections, such as eczemaⁱXA condition that causes itchy, inflamed, and dry skin and impetigo
Mouth sores
Ear infections

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Fungal infections
Autoimmune conditions
Some cancers, such as Hodgkin’s lymphomaⁱXA type of cancer that affects the lymphatic system (a part of the immune system)
Juvenile arthritisⁱXOccurrence of persistent, chronic arthritis in children and some other joint conditions

Swollen lymph nodes that appear suddenly and are painful are usually caused by an injury. Certain medications, such as typhoid immunization and seizure drugs, such as phenytoin, can also cause swollen lymph nodes in children (6).

Quick fact

Reaction to certain seizure medicines and antibiotics may cause lymphadenopathy in children (1).

Symptoms Of Swollen Lymph Nodes In Children

The most common symptoms of swollen lymph nodes are (1)

Lumps in the affected lymph node areas, commonly the sides or back of the neck
Pain, tenderness, or soreness in the affected area
Redness or warmth in the affected area
Lymph nodes may be swollen several centimeters.

Depending on the underlying pathology, the following symptoms may also be seen (6):

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Fever and chills
Respiratory issues, such as sore throat, nasal congestion, and cough
Decreased appetite
Body pain
Headache
Fatigue
Weight loss
Rash
Night sweats

Quick fact

Lymph nodes aren’t usually palpable in newborns. Palpable lymph nodes are usually observed between three and five years (9).

Complications Of Swollen Lymph Nodes In Children

Swollen lymph nodes are the body’s natural response to infections and some diseases. However, ignoring the condition may delay the treatment of a serious underlying disease or infection (1).

While swollen lymph nodes signify a problem and are not a problem themselves, the following complications may rarely occur (3).

May remain swollen or firm long after the infection has cleared up
May hamper the other functions of the body
Might break open and ooze pus

Signs You Need To See A Doctor

Contact your healthcare provider if you notice the following symptoms (1) (7):

The child develops a fever or a seizure accompanying it
Painful swollen lymph nodes
Lymph nodes that continue to grow or remain the same size beyond two weeks
A large lymph node that is firm to touch
Abnormal breathing sounds or the child complains of inability to breathe comfortably

Diagnosing Swollen Lymph Nodes In Children

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The diagnosis of swollen lymph nodes begins with a physical examination of the enlarged lymph nodes’ size and location. Further, the doctor will ask the following (1) (3):

A detailed medical history of the child
For how many days the child has been exhibiting these symptoms
Whether the child has been around children with strep throat
Whether the child has consumed any unusual food or beverages, especially unpasteurized dairy products
Whether the child has been around a young cat as a cat’s scratch can cause a mild condition called cat scratch disease characterized by enlarged lymph nodes.

After examining these details, the doctor might refer the child to a specialist and prescribe some of these diagnostic tests:

Lab tests: A complete blood count (CBC) might be performed to check the red and white blood cells and platelets. Urine tests and tests to rule out tuberculosisⁱXA disease caused by a potentially severe bacterial infection that affects the lungs might be performed.

Imaging tests: These include chest X-rays, CT scans, or MRIs to check for enlarged lymph nodes or other underlying conditions.

Lymph node biopsy: A surgeon may perform a biopsy to test the samples of the enlarged lymph nodes for different causes of enlargement. The child may be further referred to hematologists and oncologists.

Quick fact

Lymphadenopathy can affect parts of the body or the lymph nodes. The cervical (neck) lymph nodes are the most common lymphadenopathy sites (1).

Treatment For Swollen Lymph Nodes In Children

In most cases, no intervention is needed for swollen lymph nodes. When required, the treatment depends on the underlying cause. It can be done at home for mild cases, while some children may need medications to manage it. Rarely, surgical intervention may be needed (3) (7).

1. Homecare

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Ensure plenty of rest, ample hydration, and good nutrition.
Use cold or warm compresses to relieve pain in the tender region.
Give safe pain relief medications, such as acetaminophen, under the doctor’s advice. Remember, children under 19 years should not take Aspirin unless advised by a doctor, as it might put the child at risk of Reye syndrome (7).

2. Medications

The child might need antibiotics for swelling caused by bacterial infections or anti-tuberculosis medicines for tuberculosis.
The doctor might prescribe further medication based on the underlying condition.

3. Surgery

When required, surgical intervention might be suggested to remove the swollen lymph node.
A pediatric surgeon might suggest incision and drainage for the swollen lymph nodes, depending on the cause.
While surgery is generally safe, it might have some side effects, including blood clots, slow healing of wounds, risk of infection, and tingling sensation in the area of surgery (8).

Frequently Asked Questions

1. What is a concerning size for lymph nodes in children?

For children, lymph nodes of 1cm in the axilla, 2cm in the neck, and 1.5cm in the inguinal region are considered normal and do not need further investigations. However, lymph nodes that are 3cms or larger may be a cause for concern (9).

2. Is it normal to feel children’s lymph nodes in their necks?

Feeling some small, palpable lumps under your child’s skin is not unusual (10).

3. For how long can lymph nodes stay swollen in a child?

Lymph glands or nodes remain swollen as long as the infection is active. It begins to return to normal size over a few weeks (11).

4. What do cancerous lymph nodes feel like?

Enlarged cancerous lymph nodes may feel like small, movable lumps under the skin (12). Lymph nodes larger than 3cms are usually associated with malignancy (9).

5. Can a swollen lymph node be harmless?

Lymph nodes may remain swollen for a few weeks after you have been cured of the illness. In most cases, they shrink to the original size on their own. However, if they do not do so in two weeks, seek medical attention (13).

Swollen lymph nodes in children indicate an underlying issue and can have numerous causes. It can be caused by a reaction to an infection or have a more serious underlying cause, such as autoimmune diseases or cancers. Therefore, if you notice any swelling or lumps in the lymph node, contact your child’s physician and take pictures of the enlarged lymph nodes daily to track their growth. Symptoms often improve with home care; however, seeking expert advice is suggested because early intervention can help the symptoms subside faster.

Infographic : What Causes Swelling Of Each Lymph Node In Children?

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swollen lymph nodes and common causes (infographic)

Key Pointers

Bacterial and viral throat infections, respiratory infections, tooth decay, ear infections, and various autoimmune conditions can cause swollen lymph nodes in children.
Symptoms such as pain, feeling of lumps in the throat, and redness may indicate swollen lymph nodes.
Homecare measures such as warm or cold compresses and getting medications for underlying conditions help to improve swollen lymph nodes in children.

Swollen Lymph Nodes In Children_illustration

Image: Dalle E/MomJunction Design Team

Learn how to identify and manage a swollen lymph node in the neck by watching this video. Discover ways to reduce swelling and ease any discomfort it may cause.

References

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